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Donald C. Hood, Xian Zhang, Vivienne C. Greenstein, Shreya Kangovi, Jeffrey G. Odel, Jeffrey M. Liebmann, Robert Ritch; An Interocular Comparison of the Multifocal VEP: A Possible Technique for Detecting Local Damage to the Optic Nerve. Invest. Ophthalmol. Vis. Sci. 2000;41(6):1580-1587.
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purpose. To develop a quantitative measure of local damage to the ganglion
cells/optic nerve based on an interocular comparison of multifocal
visual evoked potentials (mVEP).
methods. Multifocal VEPs were recorded from both eyes of six normal subjects and
four patients; each eye was stimulated separately. Two of the patients
had glaucoma, one had ischemic optic neuropathy, and one had unilateral
optic neuritis. All four patients had considerably more damage in one
eye than in the other, as indicated by their Humphrey visual fields.
The multi-input procedure of Sutter was used to obtain 60 VEP responses
to a scaled checkerboard pattern. The amplitude in each response was
obtained using a root mean square measure of response magnitude. For
each of the 60 pairs of responses, a ratio between the amplitude of the
responses from the two eyes was obtained as a measure of the relative
health of one eye compared with the other. The mean and SD of this
ratio measure for the control group were used to specify confidence
intervals for each of the 60 locations. All patients had Humphrey 24-2
visual fields performed. To allow a comparison of the mVEPs to the
visual fields, a procedure was developed for displaying the results of
both tests on a common set of coordinates.
results. Except for a small interocular difference in timing attributable to
nasotemporal retinal differences, the pairs of mVEP responses from the
two eyes of the control subjects were essentially identical. Many of
the pairs of responses from the patients were significantly different.
In general, there was reasonably good agreement with the Humphrey 24-2
visual field data. Although some regions with visual field defects were
not detected in the mVEP due to small responses from the better eye,
other abnormalities were detected that were hard to discern in the
conclusions. Local monocular damage to the ganglion cell/optic nerve can be
quantitatively measured by an interocular comparison of the
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